A typical hospital EHR project can take at least a year. A team at health IT giant Epic has been able to stand up technology at field hospitals in COVID hot spots in a matter of days.
In all, the Wisconsin-based EHR vendor has helped to bring online 440 alternative care facilities to help expand hospital capacity throughout the country in the past four weeks. Epic has worked with 175 health systems, public health authorities and state and local governments to add up to 80,000 beds nationwide.
The key is to get creative, Epic executive Nick Frenzer told FierceHealthcare.
“We try to make it as ‘plug and play’ as possible,” Frenzer said.
Epic is providing the software, staff, and strategy for these projects at no cost. It partnered with tech giant Apple to provide some of the hardware that was needed for clinical staff such as laptops and iPads.
“We try to do as much as possible with mobile devices. We get a laptop and 30 phones and we can make that work,” Frenzer said, adding they stood up special workflows and streamlined processes for clinicians. “We want to ensure that IT does not impede providing patient care.”
As news reports detail the impact COVID-19 will have on our population and the healthcare system that serves it, many medical facilities have put systems in place to streamline services and keep frontline workers safe. Once the pandemic ends, these same procedures will remain, with clinics and hospitals looking to invest in strategies to maintain efficiency and facilitate patient and employee health.
Emergent technology like healthcare kiosks will be especially important to care providers moving forward, helping to restructure patient check-in, keep staff protected from communicable diseases, and offer easy telehealth options to less critical cases.
Healthcare kiosks streamline patient check-in
Simplifying processes continues to be an essential focus for the healthcare system, with facilities relying on websites to distribute information and nurse lines to vet cases that need to be seen immediately. These same types of efficiencies can be carried out in waiting rooms.
Offering patient check-in kiosks gives people control over their own registration process, ensuring less errors in recorded personal information and providing easy means to apply copays or pay bills at the kiosk. Streamlining these procedures frees front desk staff from data entry and allows them to focus on other tasks like scheduling or answering questions.
Delegating more control over the check-in process to the patient ensures hospital or clinic staff can concentrate on what’s most important – providing top medical care.
Minimize human-to-human contact with medical kiosks
The extensive spread of the novel coronavirus has spurred significant conversations about keeping public-facing employees safe in a variety of industries. This issue is especially vital in the healthcare industry where essential front desk staff are tasked with checking in potentially ill patients.
This greater awareness of human-to-human contact will live on with new measures to safeguard employees. Medical check-in kiosks can provide an important solution to the goal of maintaining proper social distance.
When patients can check in at a self-service kiosk, counter staff no longer risk being exposed to germs from sick individuals. Additionally, healthcare kiosks are easily disinfected. Staff can be tasked with cleaning the units, or kiosks can be outfitted with special attachments to hold sanitizing wipes or gel for patients.
Expect a solid future for telemedicine kiosks
As hospitals and clinics concentrate on keeping non-emergent illnesses out of facilities in order to make room for more critical cases, the use of telehealth options has increased.
With that, people are gaining a greater comfort level using alternative healthcare methods to communicate with a physician. In the future, telehealth kiosks placed in private areas of locations like pharmacies, schools, big box stores, and large businesses will not only provide access to medical care, but can be outfitted with special tools to help doctors retrieve necessary information like body temperature and blood pressure.
Telemedicine healthcare kiosks can also provide convenience to places with immune-compromised or elderly individuals like group homes and assisted living care facilities. These telehealth kiosks can provide on-site care easily and efficiently, reducing the need to risk exposure at a clinic or make travel arrangements for seniors to visit the doctor.
Conclusion
The pandemic has been a catalyst for innovative healthcare solutions to keep operations moving efficiently while ensuring safety is a top priority. When communities begin to emerge from the shadows again, expect beneficial technologies like patient check-in kiosks and telemedicine options to be a new expectation in the future of healthcare.
The Veterans Affairs Department has paused the rollout of its multibillion-dollar electronic health record project on account of the novel coronavirus, VA Secretary Robert Wilkie wrote in a letter to Congress on Friday.
“The worldwide pandemic created by the coronavirus disease (COVID-19) has shifted the overall priorities of the Department of Veterans Affairs,” he wrote. “Our priority is the care of veterans and providing surge capabilities for civilian healthcare systems.”
Wilkie said the VA’s office of EHR modernization has shifted to a “non-intrusive posture with VA healthcare operations” so that clinicians can focus on caring for veterans.
This marks the second delay the VA has announced this year for implementing its EHR, a multibillion-dollar contract it struck with Cerner Corp. in May 2018. The VA is co-developing the EHR system with the Defense Department.
The COVID-19 Telehealth Program will provide $200 million in funding, appropriated by Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, to help health care providers provide connected care services to patients at their homes or mobile locations in response to the novel Coronavirus 2019 disease (COVID-19) pandemic.
On April 2, 2020, the Commission released an order establishing the COVID-19 Telehealth Program. The COVID-19 Telehealth Program will provide immediate support to eligible health care providers responding to the COVID-19 pandemic by fully funding their telecommunications services, information services, and devices necessary to provide critical connected care services until the program’s funds have been expended or the COVID-19 pandemic has ended.
Questions about the application process can be emailed to [email protected].
Prior to Filing an Application:
In advance of filing an application, parties should:
Obtain an FCC Registration Number (FRN) from the Commission Registration System (CORES), as well as a CORES username and password at that link. An FRN is a 10-digit number that is assigned to a business or individual registering with the FCC and is used to identify the registrant’s business dealings with the FCC.
Obtain an eligibility determination from the Universal Service Administrative Company (USAC) by filing FCC Form 460 through My Portal on USAC’s webpage. (Filers do not need to be rural health care providers in order to file Form 460 for this program.)
Healthcare kiosks are, now more than ever, a valuable tool for serving more patients without the need for up close staff interaction. They can be used for checking in patients and gathering symptom information for efficient triage purposes. They can also be used to measure patient blood pressure or heart rate, temperature, and other diagnostic information. Moreover, healthcare kiosks are also helpful for educating patients, collecting health insurance information, and scheduling future services.
Making a healthcare kiosk accessible not only improves patient care, but is required by the Americans with Disabilities Act (ADA). The ADA prohibits discrimination against individuals with disabilities regarding public accommodations and the court has defined public accommodation to include (in title III) service establishments including healthcare facilities.
Creating an accessible healthcare kiosk
Disabilities, according to the ADA, can be physical (motor skills), cognitive (intellectual), low to no vision, low to no hearing, and more. But before addressing software accessibility, the first step to creating an accessible healthcare kiosk should be to make the kiosk physically accessible. The ability to access the kiosk by users in a wheelchair is required by the ADA. It outlines specific compliance guidelines like the height of operable parts, the viewing angle, and the approach area for accessing the kiosk — which must also be accessible via a wheelchair. The approach area requires a clear path without stairs, uneven flooring, or objects to obstruct access.
Once physical accessibility has been established, turn your attention to another an equally important component: software. The kiosk application must also be accessible for use by someone who is blind or has low vision. The kiosk needs to have a screen reader, such as JAWS® for kiosk to turn text to speech. Some examples of accessible kiosks can be found in this video.
Touchscreens may be difficult for people with disabilities, so an external input/navigation device is also useful to allow users to engage with a kiosk without using a touchscreen. The kiosk application must be developed to ensure it can be easily navigated and understood when read through a screen reader. WCAG 2.1 AA standards are application and website guidelines for accessibility. Following those guidelines with a healthcare check-in app, for instance, will make it easier for a blind or low vision user to understand and navigate the kiosk app. Learn more about selecting the right input device for your accessible kiosk.
Some things to consider when planning your accessible healthcare kiosk
What application will you be using? Is it already accessible? If yes, can you improve usability for kiosk users?
Is the kiosk hardware ADA compliant for height and reach specifications?
Does the kiosk include an input device that has an audio jack? Oftentimes, there is no effect on audio jacks built in audio jacks when headphones are inserted. Using an input device that includes an audio jack will allow JAWS to turn off and on based on the presence of the headphones.
Are you providing all information in a way that is accessible to all users, including those who are deaf or hard of hearing, and those who are blind or who have low vision? That includes any PDFs that are being read on the screen, videos in need of captioning, and document signing for HIPAA compliance.
From Becker Hospital Review Feb 2020 — Seems to be a contagion going around as far as Cerner EHR implementations go. We saw week before AdventHealth switching horses and this last week we see Atrium Health deciding to “transition” to Epic EHR.
Epic and Cerner dominate the EHR marketplace, with both companies combined accounting for more than 50 percent of the acute care hospital market share, according to KLAS.
In 2018, Epic had 28 percent of the market while Cerner had 26 percent. However, over the years Epic has gained ground as hospitals and health systems decide to switch over from Cerner or other EHR providers. In some cases, hospitals or small health systems make the switch to match larger health systems with Epic after they’re acquired. In other cases, the health systems make a change to improve efficiencies.
Epic and Cerner dominate the EHR marketplace, with both companies combined accounting for more than 50 percent of the acute care hospital market share, according to KLAS.
In 2018, Epic had 28 percent of the market while Cerner had 26 percent. It appears though that Epic has increased its percentage since then notwithstanding some large contracts wins by Cerner which include the DoD and the Veterans Adminstration. The VA is currently specing out its next generation patient check-in and it appears to be hybrid between VistA and the new Cerner. The VA leadership has stumbled some recently so whether they are on schedule or not remains to be seen.
Becker has a list of 11 hospitals which switched from Cerner to Epic in the last 5 years including AdventHealth.
Using surveys and feedback to improve patient experience
Since 2017, more than 4 million Veterans have given VA feedback on their customer experience. These surveys are usually sent to VA customers within a few days of their appointment. Recently, 88.5% of Veterans have responded that they agree or strongly agree with the statement, “I trust VA for my health care needs.” That trust question is what VA’s trust rating is based on, but the other questions in the Veterans Signals program survey helps VA pin point opportunities for improvement.
Check-in process problems
In 2018, the Lexington, Ky., VA Medical Center (VAMC) noticed a key customer experience falling short of expectations. When Veterans were asked “After I checked in for my appointment, I knew what to expect,” the satisfaction score was 82%. This alerted the Lexington VA’s Veterans Experience Officer that their patients did not understand what to expect next when checking in to appointments.
The Lexington VA then developed standard scripts and other communication aid materials to help VA employees standardize the check-in process and expectation. Also, employing a Lean Six Sigma technique called GEMBA (Japanese term meaning “the real place”) identified some key meeting places such as clinic lobbies or hallways. It then placed display boards and signs in these high traffic spots between the check-in and provider appointment locations to help patients navigate.
The results
The results pointed to an 8-point increase from 82% to 90% from the end of fiscal 2018 to the end of fiscal 2019 for the same patient satisfaction question, “After I checked in for my appointment, I knew what to expect.”
These results aren’t isolated to the Lexington VA. Improvements based on customer experience feedback are underway across the country. Customer feedback data and patient experience programs pair perfectly to improve VA’s effectiveness, ease, and empathy for Veterans, their families, caregivers and survivors.
This story is part of the Secretary’s Priorities series, which was outlined to the House Committee on Appropriations, Subcommittee on Military Constructions, Veterans Affairs, and Related Agencies on Feb. 26, 2019, by VA Secretary Wilkie. The Secretary’s Priorities are Customer Service, MISSION Act, Electronic Health Record, Transforming Business Systems, and Suicide Prevention. These stories are designed to give a closer look at the improvements VA is making in how we relate to, interact with, and ultimately serve our Veterans, their families, caregivers and survivors.
Amanda Clark is a Veteran Experience Officer at the Lexington VA Health Care System.
Shares of Phreesia (NYSE:PHR) gained 16.4% in January, according to data from S&P Global Market Intelligence . The healthcare software stock gained ground following an announcement that a health services network is integrating the company’s service.
So what
Lee’s Summit Physicians Group announced last month that it had implemented Phreesia’s patient check-in and optional payment services. In a press release, the Missouri-based healthcare services network touted the benefits and convenience offered by Phreesia’s software.
The company provides software-as-a-service (SaaS) applications for healthcare providers that help manage patient intake and payments. It generates roughly 80% of its sales from recurring revenue streams, and customers tend to stick with the company’s services once integrating them.
Kaiser Permanente nearly tripled its net income in 2019 to $7.4 billion due in large part to its investment portfolio, the nonprofit integrated health system reported on Monday. That’s up from $2.5 billion in net income in 2018.
Oakland, California-based Kaiser reported operating income of $2.7 billion and other income of $4.7 billion. Nearly two-thirds of Kaiser’s net income came from investment performance rather than its core operations.
Kaiser said the performance allows the organization to continue to make key capital investments back into the company and community. But the financials come as nonprofit healthcare operators across the country face rising scrutiny from regulators and lawmakers for mounting profits and their tax-exempt status.
